Discussing End of Life Care With Your Doctor

This article in the L.A. Times is pretty interesting, insofar as it's one of those studies where you would think the result would be obvious. Not.

The study, published online Jan. 11 in the journal Cancer, surveyed 4,188 physicians about how they would talk to a hypothetical cancer patient with four to six months to live. A majority of respondents (65%) said they would discuss prognosis, but only a minority said they would discuss do-not-resuscitate status (44%), hospice (26%) or preferred site of death (21%) at that time. Rather, they would wait until symptoms were present or until there were no more treatments to offer.

I must say, I'm pretty surprised about this. I think the time to have this discussion is before a crisis, and not at the time of crisis. Admittedly, these kinds of discussions are incredibly time-consuming but they are also necessary in order for everyone involved to have a chance to think and talk about what is wanted and what is not. Certainly, the time has to be right for the discussion. It's just that the right time is not at the end of the line.

For that matter, a cancer diagnosis is not the only kind of medical problem where this issue is relevant. It applies equally where a medical problem is very likely to be fatal in the near future, and where it is best for patients and their families to discuss their own preferences and choices for the future.